Background:. In recent times there has been an increasing trend towards surgical intervention in paediatric femoral shaft fractures with widening indications. Titanium
We reviewed eleven diaphyseal humerus fractures treated over an 18 month period, March 2004 to October 2005, using a single intramedullary Titanium
Introduction. Pediatric femoral fracture including supracondylar and subtrochantric fracture constitutes 1.6% of all pediatrics fractures. 1.
We report early major complications encountered following TEN fixation of femoral fractures in children. A case series of four children aged 8– 16 years who had primary TEN fixation of isolated femoral diaphyseal fractures. Three of the four patients had major complications. These were: significant knee stiffness requiring manipulation, haemarthrosis requiring washout and nail removal, loss of position and refracture. Two required revision to locked intramedullary nails without early complication. In the skeletally immature child TEN fixation of femoral fractures has a significant major complication rate. This needs to be recognised when comparing TEN fixation with other treatment options.
To analyse the management of open paediatric tibial fractures treated at a children's Major Trauma Centre (MTC), comparing fixation methods, union and complications. We retrospectively identified all patients admitted to RMCH with an open tibia fracture between 2008 – 2016. Demographics, mechanism, inpatient stay and follow-up management were reviewed. There were a total of 44 patients, with an average age = 10 years (3–15). 93% of cases were caused by road traffic accidents, commonly pedestrian versus car. Older children were more likely to sustain higher grade injuries, requiring increased length of stay. 35 patients had primary / delayed wound closure, 1 patient required fasciotomies and 4/44 needed skin grafts and/or flap. 7 patients were treated in plaster, 9 by
The purpose of this study was to evaluate the subjective and objective functional outcome after osteosynthesis of the forearm bone fractures with plates and screws (ORIF) or
Aim: The purpose of the study was to report the outcome of Flexible
This study is based on 286 consecutive fractures of the shaft of the humerus surgically treated in the Orthopaedic Department Spedali Civili, Brescia, from November 1996 to December 2001. Fractures were classified accordingly to AO System. A peculiar group was represented by 33 (11.5%) complex and multifragmental fractures, where the fracture involved either the shaft and the proximal metaphysis and epiphysis. Fractures were always treated by plate and screws when a deficit of the radial nerve was present, in order to allow neurolysis or nervous graft. Fractures without radial nerve lesion were treated either by plate or by endomedullary nail. In the latter group two typed of nail were used:. rigid, reamed, Kuntscher nail inserted through the proximal epiphysis.
Introduction: The traditional methods for the treatment of femoral shaft fractures of children consists of closed reduction and either spica casting or fixation by external fixator. There are also reports on the treatment of such injuries by open reduction and internal fixation by plate. In the last years the method of minimal invasive fixation of such fractures with
The traditional treatment method of pediatric femoral shaft fracture has been traction and spica casting.This method is safe but prolonged immobilization, frequent X-ray , pin tract infections are some of the disadvantages. Internal fixation has become an alternative treatment in especially children between 6-10 years. Surgical treatment has been advocated for children who have multiple injuries or severe head injury. Compression plate fixation provides rigid and stable fixation but requires extensive dissection. Fixation of the fractures with flex-ible intramedullary nailing is another alternative treatment method and is safe and effective especially in simple transverse and short oblique fractures.In the current study we tried to evaluate the results of flexible intramedullary nailing and compare them with compression plate fixation. Thirty four patients with 36 femoral segments were included to the study. Clinical and radiological records of the patients were evaluated retrospectively. Patient’s demographic data, mechanism of injury, type of treatment , duration of the operation ,age ,side were obtained from the files. 19 femoral segments were treated with compression plating .There were 13 male and 5 female patients in this group. The mean age was 7.7 (6-10).The mean operation time was 100 minutes.(75-160 minutes- time between entering and leaving the operation room )Average time to healing was calculated as 7.7 (4-10 ) months.In this group, four femoral segment non-unions and implant failures occured in 6-10 months time .These patients were managed with titanium
The type and the location of the fractures of the long bones in children that can be treated by
Aims: The purpose of this retrospective review was to analyze our results with the use of the Marchetti-Vicenzi
Introduction. Locking plates have been especially useful in the treatment of osteoporotic fractures. This study aimed to investigate the role of locking plate in femoral fractures in patients with osteogenesis imperfecta. Material & Methods. 6 male patients with osteogenesis imperfecta were operated for femoral fractures using locking compression plate. Their age ranged between 4 and 14 years. They were kept non weight bearing till the fracture united. Results. 5 patients out of 6 patients had refracture, as soon as they started walking. All 5 patients were reoperated using intramedullary titanium
Purpose of Study:. To review the outcome of paediatric patients with radius and ulna fractures treated with titanium
Congenital pseudarthrosis of the tibia remains difficult to treat. With variable success, children are subjected to many surgical procedures. We review our experience using titanium
The results of three years of treatment of children’s forearm fractures with flexible titanium nails was compared with the results from three original papers (Lascombes 1998, Richter 1998, Cullen 1998). 37 cases were identified using our trauma database and the main theatre database. 25 sets of case notes and x-rays were reviewed (age 4-16). The indication for fixation was fracture instability, either primarily or after initial conservative management. 6 cases were compound fractures. The fractures were reduced under general anaesthetic and then fixed using the ‘AO titanium
Aim: Unicameral bone cysts are difficult to treat as partial cyst healing may reverse and it may be difficult to assess between active and latent types. Materials and Methods: 19 patients with unicameral bone cysts were reviewed with a mean age of 8.5 years (16 males and 3 females). These 19 patients were reviewed over a period of fifteen years and all except one, had an active cyst abutting the growth plate. 18 cases were treated with curettage and burring using a dental burr and six cases were treated with
Femoral fractures are a common injury in the paediatric population. The purpose of this study was to audit the cost and early outcomes of femur fractures treated at the Starship Childrens Hospital. Forty-eight femur fractures treated between January 1998 and December 2002 were reviewed. 25 fractures were treated by application of an early hip spica, 12 by IM nails and 11 by other methods. Children treated by early hip spica averaged 3.8 years in age. They went to theatre an average of 29.1 hours after admission and had an average length of stay of 3.8 days. In the 30 days after discharge, five patients were readmitted for loss of fracture position. Children treated with IM
Introduction: The majority of forearm fractures in children can be managed with a plaster cast alone and manipulation under anaesthetic as required. A small number of cases however require surgical intervention. A variety of methods are available but the use of elastic intramedullary nails is becoming the technique of choice. Method: We present a two-centre study assessing the outcome of either Elastic StabJe Intramedullary Nails (ESIN) or Kirschner wires as the method of fracture stabilisation in diaphyseal forearm fractures of the radius and ulna. Results: ESIN group: 24 children underwent ESIN fixation. There were 22 boys and 2 girls, mean age 9.4 years (1.4–15.2 years, p=O.ll). Indications for stabilisation included 21 cases for fracture instability (immediate or delayed,) 2 irreducible fractures and 1 open fracture. 14 children underwent surgery on the day they sustained their fracture. The remainder were operated on an average 6.5 days following injury (1–14 days). In the K wire group: 36 children underwent K-wires fixation with 2.5mrn wires. There were 21 boys and 15 girls, mean age 10.6 years (2.2–15.5 years). Indication for stabilisation included 22 cases for fracture instability , 6 irreducible fractures and 8 open fractures. 32 children underwent surgery on the day they sustained their fracture. The remaining 4 patients were operated on the following day. Conclusions: All fractures united with no resultant subjective disability. The complication rate following K-wires was 16% and that following nail fixation 9%. Loss of forearm rotation was documented in 4 children in the K-wire group and 3 children stabilised with nails. These results confirm an excellent outcome following intramedullary fixation. We have demonstrated no difference in outcome between K-wires and ESIN, although the
Today more and more papers are published about the operative treatment of femoral fractures in children and even uncomplicated and isolated fractures are treated by using